Spasticity: How to Treat Muscle Tightness and Pain

Imagine wanting to stretch out your legs or arms — to open and close your hands or to flex your feet — and not being able to because the muscle is simply stuck, tightened or contracted.

This is a constant experience for people with spasticity.

Spasticity is a muscle control disorder. It causes tight or stiff muscles and an inability for people to control certain muscles. This can make it hard to walk, get dressed or even speak.

Unfortunately, spasticity affects more than 12 million people around the world, including about 80 percent of people with cerebral palsy.

What causes spasticity?

Normally, our brains send signals down the nerves in our spinal cord that tell our muscles when to tighten or relax. Without thinking about it, we use these signals to control how we move, contracting and releasing different muscles as we stand up, walk across a room, put on our clothes and more.

People with spasticity have lost control of part of that connection between the brain and the muscles. A signal gets stuck in the “on” position. This causes certain muscles — usually in the legs, but sometimes in the arms — to remain contracted or tensed.

It is caused by damage to the spinal cord that occurs in people with cerebral palsy, traumatic brain injury, stroke or other conditions that affect the brain or spinal cord. In cerebral palsy, the damage isn’t reversible, meaning true spasticity doesn’t go away on its own.

What are the symptoms?

Spasticity usually affects the legs, but can also affect the arms. It can cause symptoms such as:

  • Muscle spasms and involuntary tensing
  • Increased muscle tone
  • Overactive reflexes
  • Pain and discomfort
  • Trouble functioning or moving
  • Problems with self-care and hygiene
  • Abnormal posture
  • Bone and joint deformities
  • Contractures (permanent tensing of the muscle due to severe, lasting stiffness)

Most cases of cerebral palsy spasticity develop in childhood or adulthood, but it can affect babies with severe cerebral palsy.

What are the treatments?

When spasticity causes pain or keeps people from going about their daily activities (including sleep), it may be time to treat. Treatment options vary from person to person based on age, functional ability, severity of the spasticity and the underlying cause.

Regardless of the treatment, the goal is to relieve pain and reduce the muscle tension. This can make it easier to get dressed, walk, eat and bathe.

Non-medical treatments include:

  • Physical and occupational therapy (stretching, exercises)
  • Braces and casts
  • Cold packs
  • Electrical stimulation of the nerves

Medical spasticity treatment options include:

  • Pain medicine
  • Muscle relaxant medicine, either by mouth or through a small implanted device under the skin
  • Orthopedic surgery to cut the muscle’s nerves, causing permanent relaxation of the muscle
  • Selective dorsal rhizotomy, a surgery to cut only the nerves causing spasticity (leaving unaffected nerves to control the muscle)

As a physician who has treated spasticity for more than 20 years, I know the impact it can have on the lives of patients and caregivers. I urge you to explore your options for care so that it doesn’t cause constant pain or problems with daily activities.

If you or a loved one are affected by spasticity, consider working with a team of healthcare professionals to decide on the best course of action. Our expert team of pediatric neurosurgeons, neurosurgery nurse practitioners and therapists offer the complete spectrum of multidisciplinary care.

Jeffrey Leonard, MD
Jeffrey R. Leonard, MD, is chief of Neurosurgery at Nationwide Children’s and professor of neurological surgery at The Ohio State University College of Medicine. Dr. Leonard has authored more than 75 publications, presented invited talks nationally and internationally, held leadership positions in several major neurosurgical organizations, and been the recipient of several teaching awards. Most recently, in 2015, he published the book “Chiari I Malformation” with other leaders in the field. Dr. Leonard is internationally recognized for his dedication to improve treatment for childhood brain tumors and has received grant funding for this work in studying their genetic profiles. He has also performed innovative investigations in the field of pediatric head trauma.

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